- End of life care affects everyone, death comes to us all, but end of life care specifically relates to those that are likely to die within the next 12 months.
- Each year there are around 3,200 deaths in Wakefield.
- The main causes of death are cancer, circulatory disease and respiratory disease.
- Death rates are higher in Wakefield than other comparable areas and more people die prematurely.
- An estimated 2,200-2,600 people may need palliative care in Wakefield each year, however not everyone needing palliative care will require end of life care.
- The proportion of people in Wakefield who die in their usual place of residence is increasing, but at a slower rate than in other comparable areas.
- Those dying from Circulatory disease or Dementia and Alzheimer’s disease in Wakefield are less likely to die in their usual place of residence than in other comparable areas.
End of life care affects everyone, as death comes to us all. People are considered to be approaching the end of their life when they are likely to die within the next 12 months. This includes people whose death is imminent and those with conditions, frailty or co-existing conditions that mean they are expected to die within 12 months. Including people that have existing conditions, if they are at risk of dying from a sudden acute change in their condition and people that have life-threatening acute conditions caused by sudden catastrophic events. It also includes those who are diagnosed as being in a persistent vegetative state for whom a decision to withdraw treatment may lead to their death.
End of life care should help people who are in the last stages of their life to live as well as is possible until they die, and to die with dignity.
Each year in Wakefield district there are around 3,200 deaths, this is around 1% of the population. The main causes of death are cancer (28%), circulatory disease (26%) and respiratory disease (16%).
Research suggests that 69-82% of people who die need palliative care. Palliative care improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Not everyone needing palliative care will require end of life care, as they may not be likely to die in the next 12 months. It is estimated that 2,200-2,600 people in Wakefield need palliative care each year.
Death rates are higher in Wakefield district than other comparable areas, with more people dying prematurely (under the age of 75 years), more information on causes of death can be found on our deaths page. It is estimated that 69-82% of people who die need palliative care, indicating there may be around 2,200 and 2,600 people each year in Wakefield.
An indicator for quality of end of life care is dying in your usual place of residence; two thirds of people would prefer to die at home.
The latest data shows the percentage of people dying in their usual place of residence is increasing in Wakefield; but not as fast as in other areas and Wakefield has a lower proportion of people dying in their usual place of residence than other comparable areas and the national average.
Those dying from Circulatory disease or Dementia and Alzheimer’s disease are in Wakefield are less likely to die in their usual place of residence than other comparable areas, the proportion of people with dementia dying in hospital is much higher.
Source: Public Health England
The infographics below show some of the inequalities in end of life care for the deaths of Wakefield residents registered between 2011 and 2017. Death in usual place of residence (DiUPR) is used as an indicator for quality of end of life care; typically two thirds of people prefer to die at home or their place of residence (including care homes) and therefore a figure for DiUPR indicates better quality end of life care. In Wakefield 41% of individuals die in their usual place of residence, which is lower than the national average of 46%. There are differences in this percentage when looking at men and women and geographic area of Wakefield. There is no significant trend associated with deprivation for this data.
Specialist organisations offer specialist palliative care across a variety of settings to people with life limiting conditions who have:
- Active, progressive advanced disease
- Malignant and non malignant disease
- Unresolved complex needs that cannot be met by their existing care team
These services offer holistic care that addresses people’s physical, psychological, social and spiritual needs. They also offer support to families and carers both before and after bereavement.
Details about the specific services the different specialist organisations offer is listed below.
The Prince of Wales Hospice provides care to people living in the Five Towns area. They offer:
- Inpatient care on 13 bedded unit
- Day therapy based in the hospice
- An outreach service at 3 community venues
- Lymphoedema service for people with primary and secondary lymphoedema. The service operates at the Prince of Wales Hospice, Wakefield Hospice and Rosewood Hospice
- A 24 hour helpline for patients, carers and health professionals
Wakefield Hospice provides care and support to people living predominantly in the WF1-WF5 areas. They offer:
- Inpatient care on 16 bedded unit
- Drop in day therapy for patients and carers – based in the hospice
- A Drop in and 1 to 1 bereavement service for families bereaved at the hospice
- And End of Life Admiral Dementia Nurse to support people living and dying with a dementia diagnosis
- A 24 hour helpline for patients, carers and health professionals
The Mid Yorkshire Macmillan Specialist Palliative Care Team (SPCT) provides an advisory service, working alongside the primary treating team (hospital consultant or General Practitioner (GP)) who will retain clinical responsibility for the patient. The team is divided into 2 operational units that can provide cross cover for each other if required, offering:
- A hospital service providing support for patients in all three hospital sites in the Mid Yorkshire Hospitals Trust
- A community service covering patients within both the Pontefract and Wakefield areas
- A consultant-led outpatient clinic is offered at all three hospital sites and medical staff provide domiciliary visit in the community areas.
The Yorkshire Cancer Patient Forum is a group of people who have been directly affected by cancer, and those working with or within cancer services. Their aim is to enable the views and experiences of cancer patients, families and friends to be heard and used to improve the quality of cancer care in the Yorkshire and Humber area. They do this by working in partnership with local health teams and other voluntary organisations. Macmillan has funded a full time engagement and communications officer to support the Forum, who is based with and managed by Healthwatch Wakefield.
Information and Publications
RightCare packs – NHS RightCare is a national programme supported by NHS England to deliver the best care to patients. The RightCare packs support areas to identify where they differ from other similar areas, and what areas of a pathway could be changed to be more efficient and effective. End of Life information can be found here starting on page 131.
Download the Death in Usual Place of Residence infographic here